John Thorne Crissey

The decubitus ulcer in clinical practice

Background.- 1 Bedsores over the Centuries.- 2 Decubitus: The Word.- 3 Incidence, Prevalence, and Classification.- 4 Assessment and Grading.- Clinical Aspects.- 5 Pathophysiology.- 6 Clinical Picture.- 7 Atlas.- 8 Histopathology.- 9 Bacteriology.- Therapy - General.- 10 Medical Management.- 11 Surgical Management.- 12 Rehabilitation Approach.- Therapy - Specific.- 13 Occlusive Dressings.- 14 Support Systems.- 15 Antimicrobial Therapy.- 16 Nutritional Perspectives.- 17 Incontinence Management.- Additional Concepts.- 18 Legal Aspects of Medical Malpractice: Cases Involving Decubitus Ulcers.- 19 Can Do, Ought To? Decision: Is It Truly Dilemma?.- 20 Decubitus Ulcers in Animals.

Cosmetics: A historical review

Abstract The use of cosmetics predates written history. But the reasons for their use—the attraction of lovers, intimidation of the enemy, masking the effects of advancing age, and compensation for exterior defects, real and imagined—are so intimately associated with activities embedded in the double helix of mankind that we can safely assume the existence of a paleocosmetology in all our ancestral prototypes. 1 Approval and use were nearly universal in all the older civilizations for which records exist. The association of cosmetics with immortality, pretense, and deceit that characterized the anti-Dionysian mindset of the power structure of the Western World in the later years of the 19th century and the early years of the 20th was never shared by the rest of the planet. 2

Assessment and Grading

Because of our aging population and advances in medical and surgical therapy permitting survival from catastrophic illness and injury, the incidence of decubitus ulcers is likely to increase unless greater attention is paid to prophylaxis. At present, there is more interest in treating and curing than in avoiding injury and illness. We must become more prevention oriented; with cost restraints limiting resources, not everyone can be offered perfect decubitus ulcer prevention. The patient at greatest risk must be identified before the problem begins. Our limited equipment and personnel have to be concentrated on those patients at highest risk.

Wound healing: Development of the basic concepts

Abstract Since the literature dealing with wound healing from ancient times to the end of the 18th century is entirely clinical, the subject in all of the older accounts is bound up inextricably with wound management. The number of such accounts is understandably large. Whether presented ready-made or produced on an elective basis, wounds have always been the stock in trade and the favorite literary subject of surgeons, and every practitioner of the chirurgical arts is forced to come to grips with the problems associated with them. Wounds figure prominently in the oldest of the surgical treatises, the Edwin Smith Papyrus (c 1600 B.C.E.) where, in contrast to the fuzziness associated with ordinary disease descriptions in Egyptian documents, accounts of injuries and their management leap across the millenia to the mind of the modern reader with startling clarity. 1

Clinical picture of infectious syphilis

Abstract A generation ago, when syphilis was a clinical commonplace and a subject heavily stressed in the medical school curriculum, syphilologists were concerned that students preoccupied with the fascinating signs of the disease would forget that the diagnosis is properly made on the basis of laboratory findings. Today the pendulum has swung the other way. Exposure to the clinical aspects of syphilis is so limited during student years, and the teaching of the subject so erratic, that even the most classical and striking forms of the disease often go unrecognized. Laboratory tests are performed and requested when they are not indicated and overlooked when the need for them should have been obvious, particularly in the secondary and relapsing forms of the disease. That the diagnosis of syphilis in its early stages is a laboratory matter is as true now as ever, but the stimulus to perform the tests is provided by the clinical situation at hand. It is the purpose of this section to describe the signs and symptoms that ought to provide that stimulus.

Bedsores over the Centuries

Decubitus ulcers, pressure sores, or bedsores (take your choice) have been recognized since antiquity. From the sixteenth through the eighteenth century they were considered occasionally and usually indirectly in treatises on gangrene [1]. The subject, however, was evidently so much a matter of common knowledge in possession of everyone concerned at the time with patient care that discussions in print were seldom considered necessary, and certainly no great literature devoted to it existed prior to 1800.

Immunology of syphilis

Abstract It is an accepted and well-documented fact that man and rabbits inoculated with T. pallidum eventually develop resistance to the organism. 1–4 Following infection, multiple antibodies appear in the blood of both species, and much evidence has recently been produced to document the presence of cell-mediated responses as well. The exact role played by each in protecting the host against the invading organism and in contributing to the clinical manifestation has not yet been worked out satisfactorily, although investigations currently underway in many places promise much for the future. 5–7 In the description and analysis of the recent work on the immunology of syphilis, it is useful to separate the humoral and cellular components of the immune response, but it must always be kept in mind that they act in concert in the natural course of the disease.

Japanese and American Dermatology: Parallels and Interactions

medicine was Chinese medicine. The medical system known as Kampō and the therapeutic modalities associated with it were imported from mainland China by way of Korea. As far as skin diseases are concerned, treatment consisted mainly of balneotherapy, acupuncture, moxibustion, and the application of tarry ointments (1). As is usual in the medical literature of the ancients in all cultures, the treatments themselves are far better described than the diseases for which they were recommended.

Treatment of infectious and latent syphilis

Abstract The current treatment of all stages and all forms of syphilis is by the administration of antibiotics. In this section, effective dosage schedules and suitable monitoring and follow-up procedures essential to the proper management of infectious and latent syphilis are outlined. Certain practical difficulties encountered in putting these procedures and programs into operation are also described.

Bibliography of secondary sources on the history of dermatology. II. Obituaries and biographies in English journals supplemented through 1975.

This supplement brings through 1975 the available journal articles of a biographical nature. The various rules outlined in earlier installments have been followed as closely as possible. An * indicates that additional material may be found in a previous installment. These were: I. Journal Articles in English. Arch. Dermatol. 108:351, 1973. Supplemented through 1975. Int. J. Dermatol. 15:525, 1976. II. Obituaries and Biographies in English Journals Before 1973: A Through L. Arch. Dermatol. 111: 1036, 1975. M Through Z. Arch. Dermatol. 111: 1188, 1975. 111. Books, monographs and Chapters in English before 1975. Int. J. Dermatol. 15:206, 1976.